摘要
目的：应用超声成像技术检测正常小儿髋关节结构，为采用超声早期诊断小儿髋关节发育紊乱提供依据。方法：采用５．０ＭＨｚ线阵超声仪，根据Ｇｒａｆ－Ｓｃｈｕｌｅｒ法对婴儿髋关节进行额状面扫描，结合Ｘ线双髋检查，共筛选出９３例１８６侧正常髋关节。婴儿超声受检时间为出生后１８．６±１．２天，Ｘ线受检时间为出生后５２±４个月。结果：超声可以在声像上基本再现髋关节解剖额状面结构：（１）皮肤、皮下组织、筋膜、臀肌、关节囊显示清晰；（２）随年龄增大，在股骨近端图像中新生儿软骨－骨缘曲线内侧支逐渐下降，股骨头骨化中心成熟和扩大，呈现典型的“半月征”；（３）利用骨性和软骨性髋臼的回声差别，在出生后即能判定髋臼的发育情况，确定髋臼对股骨头的覆盖程度；（４）通过动态检查股骨头在髋臼内的稳定性发现，当向头侧推挤股骨时，软骨髋臼顶有轻度变形，β角平均增大约２°，α角无改变。当解除推力，并向下牵拉时，β角则恢复正常。结论：超声检查婴儿髋关节操作方法简捷、快速、经济、无侵袭性。
5.0 Mhz linear ultrasonic scanner was used for the frontal ultrasonographic sectional study of the infant hip according to the method of Graf- Schuler; with combined observations of the X- ray findings of bilateral hips, 186 normal hips of 93 cases were scanned. In average, the time of ultrasonic examination was carried out at the 18.6± 1.2 days after birth and the time of X- ray examination was at an average of 52± 4 months. The results revealed that ultrasonic examination basically demonstrated the anatomy at the frontal profile of the hip joint. (1) the skin, the subcutaneous layer, the fascia, the gluteul muscles, and the joint capsule were clearly seen; (2) Along with the increase of the infant age, the picture of the proximal end of the femur showed a gradual lowering of the medial branch of the chondro- osseous curvature, in addition to the maturation and expansion of the ossification center of the femoral head, assuming a typical semi lunar shape sign;(3) By means of identifying the difference of the resonance from the cartilaginous acetabulum and osseous tissue, the degree of coverage of the femoral head by the acetabulum can be determined soon after birth; (4) dynamic examination of the stability of the femoral head within the acetabulum demonstrated that, a forward pushing of the femur caused slight deformation of the acetabulum roof; there was an average increase of the beta angle for 2 degrees, and there was no change of the α angle. When the pushing force was released with simultaneous down pulling, the β angle restored to normal. Ultrasonic examination of the infant hip is a convenient, fast, non- invasive method of study, and is valuable for the early diagnosis of developmental disturbance of the infant hip.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第6期356-359,共4页
Chinese Journal of Orthopaedics
